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目的:探讨血清脑源性神经营养因子（brain-derived neurotrophic factor, BDNF）与急性缺血性卒中患者卒中后认知损害（post-stroke cognitive impairment, PSCI）的相关性，并评估其对PSCI的预测价值。方法:前瞻性纳入2018年4月至2020年9月济宁医学院附属医院收治的急性缺血性卒中患者。在发病后3个月时采用蒙特利尔认知评估量表（Montreal Cognitive Assessment, MoCA）评估认知损害。采用多变量n logistic分析确定血清BDNF与PSCI的独立相关性，并采用受试者工作特征（receiver operating characteristics, ROC）曲线评估其对PSCI的预测价值。n 结果:共纳入511例急性缺血性卒中患者，男性332例（65.0%），年龄（60.67±10.18）岁（范围49~80岁）；基线美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale, NIHSS）评分中位数5.0分（2.7~6.7分），前循环卒中413例（80.8%）；血清BDNF中位数11.54 μg/L（6.13~16.25 μg/L）。310例（60.7%）发生PSCI。单变量分析显示，PSCI组年龄、既往短暂性脑缺血发作史、基线NIHSS评分和血清BDNF与非PSCI组差异存在统计学意义（n P均<0.05）。多变量n logistic分析显示，血清BDNF与PSCI存在显著独立相关性（优势比0.514，95%置信区间0.356~0.807；n P=0.005）。ROC曲线分析显示，血清BDNF预测PSCI的曲线下面积为0.863（95%置信区间0.830~0.896；n P<0.001），最佳截断值为10.78 μg/L，敏感性和特异性分别为74.9%和86.8%。n 结论:基线血清BDNF较高是PSCI的保护因素，对PSCI具有良好的预测价值。“,”Objective:To investigate the correlation between serum brain-derived neurotrophic factor (BDNF) and post-stroke cognitive impairment (PSCI) in patients with acute ischemic stroke, and to evaluate its predictive value for PSCI.Methods:Patients with acute ischemic stroke admitted to the Affiliated Hospital of Jining Medical University from April 2018 to September 2020 were prospectively enrolled. Cognitive impairment was assessed by Montreal Cognitive Assessment (MoCA) at 3 months after onset. Multivariate n logistic analysis was used to determine the independent correlation between serum BDNF and PSCI, and receiver operating characteristics (ROC) curve was used to evaluate its predictive value for PSCI.n Results:A total of 511 patients with acute ischemic stroke were enrolled, including 332 males (65.0%), aged 60.67±10.18 (range 49-80) years. The median score of the National Institutes of Health Stroke Scale (NIHSS) at the baseline was 5.0 (interquartile range 2.7-6.7), and 413 patients (80.8%) had anterior circulation stroke. The median of serum BDNF was 11.54 μg/L (interquartile range 6.13-16.25 μg/L). PSCI occurred in 310 patients (60.7%). Univariate analysis showed that there were significant differences in age, history of previous transient ischemic attack, baseline NIHSS score and serum BDNF between the PSCI group and the non-PSCI group (all n P<0.05). Multivariaten logistic analysis showed that there was a significant independent correlation between serum BDNF and PSCI (odds ratio 0.514, 95% confidence interval 0.356-0.807; n P=0.005). ROC curve analysis showed that the area under the curve of serum BDNF predicting PSCI was 0.863 (95% confidence interval 0.830-0.896; n P<0.001). The best cut-off value was 10.78 μg/L, and the sensitivity and specificity were 74.9% and 86.8% respectively.n Conclusion:Higher baseline serum BDNF was a protective factor for PSCI and had good predictive value for PSCI.